The Omicron sub-variant BA.5 became the dominant variant in the United States last week, according to data from the US Centers for Disease Control and Prevention, and the sub-variant carries key mutations that help it escape antibodies from previous vaccines and infections, helping it spread rapidly.
This will come with “increasing numbers of cases and more hospitalizations,” Dr. Eric Topol, a cardiologist and professor of molecular medicine at Scripps Research, told CNN. “One of the good things is that it doesn’t seem to be associated with ICU admissions and deaths like the previous variants, but that’s certainly worrisome.”
But given the number of official cases, it’s hard to tell.
Dr Michael Mina, an epidemiologist and chief scientific officer of telehealth company eMed, said the proportion of officially reported cases is at an “all-lowest level”. “There is no doubt about that.”
The number of Covid-19 cases has been somewhat underestimated throughout the pandemic for reasons including a lack of available tests at some points and asymptomatic cases that may have been missed. But as people increasingly rely on rapid home testing — and with attitudes toward the pandemic in general shifting — the United States has not adopted a reliable way to track transmission levels.
An estimate from the Institute for Health Metrics, a research center at the University of Washington, suggests that actual numbers of infections in the first week of July were about seven times higher than reported cases — which averaged about 107,000 cases per day over the past two weeks, according to University data. Johns Hopkins.
Before the CDC lifts the requirement for international travelers to be tested before coming into the country Mina said, last month, it was a “fantastic opportunity” to monitor a case of Covid-19 across the United States among a group of people who are often asymptomatic. About 5% of travelers have tested positive throughout May, which he says may translate into at least 1 million new infections each day in the broader US population — 10 times higher than the official number.
Now that you’re BA.5 here, “We know there’s going to be a wave in the fall – there’s almost no doubt about that – if not before. So you just have to be really aware that’s what might happen,” Mina said.
But with so many variables at play, it doesn’t necessarily make sense to compare the current state of things to other points in the pandemic.
“We don’t really have a good understanding of the baseline,” said Dr. Marcus Plesia, chief medical officer of the Association of State and County Health Officials. “To say ‘Here’s where we are, at this time in 2022, compared to 2021’ – that’s not a fair comparison.”
To assess your individual risk of Covid-19 as a new variable takes hold, personal accounting of cases among friends and family may be a better measure than official data, experts say.
“People ask each other, they exchange stories, and that’s probably not a bad source of evidence,” said Baruch Fischoff, a professor at Carnegie Mellon University and the founding chair of the FDA Risk Communication Advisory Committee.
He said that our social networks may have remained more consistent than national surveillance systems, and “if more people in your circle you hear about are getting sick now than they did in the past, and the size of your circle is about the same, then there should be disease now.” Much more than it was before.”
Dire consequences do not tell the whole story
At the White House’s Covid-19 response team briefings — the most recent of which took place more than two weeks ago — CDC Director Dr.
Months ago, the CDC shifted away from levels of Covid-19 transmission that ranked risks based on the number of cases and testing positivity rates to focus on Covid-19 community levels that rely more on measures related to hospitalization.
During this winter’s Omicron wave, hospitalizations and deaths did not follow the same sharp trend line as cases — an important shift from previous pandemic waves.
But experts say the fact that serious outcomes are still occurring at all is reason enough to continue to care about cases.
“If we ever get to a situation where people get infected but it doesn’t cause any serious disease anymore — it might be a newer species that is much less dangerous, or it hasn’t been causing Covid for a long time — if it wasn’t there,” said Jason Salemi, an epidemiologist and associate professor at the University of South Florida:
“But let me be clear, we’re not there yet.”
There is no evidence that BA.5 causes more severe disease, but studies have shown that BA.5 can evade antibodies from vaccination or previous infection – even from the Omicron subvariant. Vaccines are still expected to provide protection against severe disease, and in the fall, vaccine makers are developing updated booster shots that include Omicron BA.4 and BA.5 strains.
There are treatments available, such as the antiviral Baxlovid pill, that greatly reduce the risk of death or severe illness. And high-quality masks, ventilation, physical distancing, quarantine and isolation can still help reduce spread of any kind, including BA.5.
But right now, more than 5,000 people are hospitalized with Covid-19 every day, CDC data shows, and more than 300 people die every day, according to JHU data.
Focusing on these “lagging indicators” would cost “meaningful time to start curbing people’s behavior and preventing a lot of diseases and deaths,” Al-Salmi said.
If 1 in 5 Covid-19 infections result in prolonged Covid and the true infections are seven times higher than reported, the number of people with prolonged Covid-19 could grow by 100,000 each day.
Working around blind spots
Plesia said the US is currently in a “sustainable management phase” with continued efforts to keep things in check compared to “what was much more of a reactive, emerging and emerging approach in the past”.
But the federal government recently reallocated resources away from testing Because Congress has not approved the additional Covid funds, a move Mina says would leave the US “very blind as we move in the fall.”
Some monitoring programs are underway, such as sewage monitoring that tracks the amount of virus present in sewage. But he says they are “too little,” and “in general, they don’t really give us a good picture of what’s really going on across the United States.”
“We just got through this big outbreak,” Mina said, referring to the previously prevalent Omicron sub-variables. “But we shouldn’t let our guard down, I would say, because with BA.5, I expect it to be a very different story.”
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